Waiting periods for abortion

There has been much coverage recently of the policy paper on what the law might be if the 8th Amendment is repealed. The Times highlighted point 8 in this policy paper, a policy which would potentially add a waiting period for women who request a medical abortion, i.e. abortion prior to 12 weeks using pills, and notes that this might be a 3 day waiting period. I have written to Simon Harris and my own local TDs, urging them to reconsider this, in the hopes that they will examine the evidence which suggests that a waiting period is not beneficial and is, in fact, detrimental to women in a number of ways.

Waiting periods for termination present a number of barriers for women hoping to access this service. Many people will have difficulty getting time off work to attend an appointment in the first place, especially those in less secure jobs, jobs without sick leave, jobs with zero hour contracts, etc. and to force them to take two days off will be prohibitive. Many GPs have long waiting lists for appointments, and regularly run over-time and behind schedule – my own GP needs to be booked at least a week or two in advance for an appointment, and unless you are the first in the door, you will likely be sitting in the waiting room for a long time beyond your appointment. In some cases, I’ve waited for over an hour or more beyond my scheduled time. To ask women in a vulnerable employment situation to do this twice, while employers chastise them for lateness or missing work, or to ask women attempting to seek a termination without letting others know to explain prolonged absences like this not once but twice is prohibitive, and will prevent women from accessing the care they need.

Waiting periods are almost never required for other medical procedures, so there isn’t a good medical reason to apply a waiting period to this procedure. I, for example, have had my appendix removed, and have had laser eye surgery, and I was able to access both of those irreversible medical procedures on request, without the imposition of a waiting period.

All the best evidence shows that when women arrive at a medical facility seeking termination, they have made their decision and that decision is fixed. Waiting periods are rooted in the idea that they may change their minds, but evidence shows that a majority of people do not. Moreover, there is an infantilising and slightly insulting undertone to the waiting periods that women may simply be too emotional, too flighty, or otherwise unqualified to make and commit to a decision, or to make a decision and then not change their minds afterwards.

Waiting periods, far from making sure women are able to change their minds and protecting them from regretting or being upset by their decision, are actually detrimental to the mental health of women. One third of surveyed patients in Texas, for example, felt that the mandatory waiting period had a negative effect on their mental state.

Adding a waiting period also led to difficulties with women accessing termination, which often led to later term abortions taking place. While the risk for all kinds of abortion is very low, that small risk does rise with later gestational age, and waiting periods delay this treatment for an unspecified amount of time, as there is no guarantee that a woman might be able to return precisely three days later, either due to her own schedule, or to the GPs schedule.

I understand that there is a perception that people might be pressured into a termination, or might regret it or change their minds, but the evidence overwhelmingly does not back this up. The vast, vast majority of people are sure of their decision when they seek a termination, and they don’t regret it afterwards either.

A study of Wisconsin’s 2013 mandatory preabortion ultrasound law found that 93% of women were certain in their decision to obtain an abortion, both before and after the law was implemented.5

A nationally representative survey of abortion patients conducted in 2008 found that 92% of women reported they had made up their mind to have an abortion prior to making an appointment.6

According to a study of women seeking abortion at a U.S. clinic in 2008, 99% of abortion patients reported being “sure” or “kind of sure” of their decision to have an abortion, and 98% reported that “abortion is a better choice for me at this time than having a baby.”7

A 2015 qualitative study on travel-related barriers to abortion found that facing multiple barriers, such as limited access to clinics and financial constraints, had a cumulative impact on abortion access.8 The study authors considered waiting periods to be harmful in the context of these barriers.

In a 2014 study of Utah women seeking an abortion, 74% of participants said that the 72-hour waiting period did not affect the certainty of their decision to have an abortion and 17% said that the waiting period made them more certain about the decision.9

The percentage of women who regret having a termination is very small, and has been over-blown and misrepresented by pro-life advocates during their campaign. There is ample evidence which tells us that the majority of women believed it was the right decision for them. Allofthesestudies confirm that women felt their decision was the right one for them, with no regrets, or regrets only that they had to do something illegal in their own country.

In summary, women don’t change their minds because of waiting periods, and they feel their decision (which was already made when they sought a termination) was the right one for them. The primary contributing factors in women who did have negative feelings was the stigma associated with abortion, something which will not be helped by a waiting period and the associated perception that women might choose abortions on a whim, or change their minds if they sleep on it.

Adding a waiting period just imposed a barrier and makes it more difficult for a person to access the healthcare they need. It adds a time and travel barrier, a cost barrier, an access barrier. It adds no benefit. None. Adding a waiting period is not compatible with any system which would claim to “trust women” as it implies that we can’t be trusted.